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If changes to lifestyle and diet have not worked to treat constipation, a laxative can be taken in pregnancy if recommended by a pharmacist, midwife, or doctor.
What is constipation?
Constipation is when you can’t poo properly - either because you are not going to the toilet regularly, because your poo is hard or difficult to pass, or you still feel like you need to go to the toilet after you have been. Constipation is common in pregnancy due to normal hormonal changes.
How can I treat constipation?
Sometimes changing your diet and lifestyle can improve constipation. This includes:
• Increasing the fibre in your diet – adding more fruit, vegetables, and fibre supplements like bran can help
• Drinking plenty of fluid
• Making sure you are mobile, ideally by doing some exercise
If these do not work, then you might need to take a laxative.
Benefits
What are the benefits of using a laxative in pregnancy?
If diet and lifestyle changes haven’t helped, a laxative can be used to soften your poo and help your bowels move more easily. This can relieve the discomfort of constipation, including bloating and gas.
Risks
What are the risks of using a laxative in pregnancy?
There are no known risks, but some types of laxatives are preferred over others in pregnancy because of the way that they work:
• Bulk-forming laxatives (like wheat bran, ispaghula [Fybogel®, AaceGel®, Ispagel®, YourFibre®] and methylcellulose) are often tried first and are safe in pregnancy.
• Osmotic laxatives (like lactulose [Duphalac®, Lactugal®] and macrogols [Movicol®, Laxido®, CosmoCol®, Molaxole®, TransiSoft®] increase the amount of water in poo and are normally tried next. They are not absorbed into the body and therefore will not reach the baby.
• Docusate sodium (Dioctyl®) makes poo softer and easier to pass. Studies have shown that it does not harm the baby.
• Stimulant laxatives (like bisacodyl [Bisacodyl®, Dulcolax®], sodium picosulfate, and senna [Cenlax®, Senease®, Sennosides®, Senokot®] help the bowel move poo along. Because these laxatives stimulate muscles, there has been theoretical concern that they could cause womb contractions. However, this has not been observed in pregnant women. Stimulant laxatives only tend to be tried when those above have not helped.
• Other types of laxatives (like linaclotide [Constella®], and glycerine suppositories) can be used if nothing else has worked. They are not thought to cause any harm. Linaclotide is not absorbed into the body.
Alternatives
Are there any alternatives to taking a laxative in pregnancy?
As discussed above, constipation can sometimes be improved with changes to diet and lifestyle.
No treatment
What if I prefer not to take medicines in pregnancy?
If you want to avoid using medicines, you can use diet and lifestyle changes described above to treat constipation. However, use of a laxative in pregnancy will not harm your baby.
Will I or my baby need extra monitoring?
As part of routine antenatal care, most women will be offered a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. No extra monitoring is required following use of a laxative.
Are there any risks to my baby if the father has taken a laxative?
There is no evidence that laxative used by the father can harm your baby through effects on the sperm.
Who can I talk to if I have questions?
If you have any questions about the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.